Right on, Lynn:  Hand expression is the way to go!  I have previously
posted on this, making the same observations you came up with.  Women in
the rest of the world hand express for their babies (including SCN babies)
and do so quite well, thank you.  Those of you who live outside the US may
agree or disagree but I recently read somewhere (can't quite remember
where, but I was bottlefed, so...) that US babies have 96% of the neonatal
technology that is available thruout the world today available to them. By
technology, I mean things like incubators, warmers, etc.  Much of the rest
of the world "gets by" on Kangaroo care, rooming-in, mothers having to hand
express their milk for their preemie babies, etc.
When did we get so hung up on technology?  This "I have to have the latest,
most expensive, best, fill-in-the-blank gadget" is truly what is driving
down the duration rate of breastfeeding.  I think we're headed down the
same path as formula usage.  As US technology spreads thruout the rest of
the world, I believe we will see a corresponding drop in breastfeeding
duration rates, such as is currently being seen here in the US.  I run a
very popular support group for breastfeeding moms and none of these women
use a pump more often than absolutely necessary (some of them work outside
the home) and all of them make it to at least the 1 year mark.  Intersting
concept for a study, perhaps?
By the way, I hand expressed milk for all 3 of my children while working
full-time.  I also teach hand-expression to the mothers I work with.  Every
few months or so, I will teach hand-expression in the support group using a
willing mom and they are always amazed at how far she is capable of
squirting (in public, no less!).  And of course, some of you will remember
my UCLA lectures presented during the times I was actively nursing and
demonstrating hand-expression using myself in front of 40 students!

Pam Hirsch, RN,BSN,CLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL  USA

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